Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less often affected by osteochondrosis than the cervical and lumbar spine. This is because it is relatively inactive, stable and well reinforced by a muscular corset. Its complications are even rarer - disc protrusion and herniation.
However, this disease presents many symptoms that significantly reduce the quality of life and therefore require treatment. The use of medications only alleviates symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to influence the cause of the development of degenerative processes in the discs. For this purpose, the clinic uses complex therapy, which gives positive results in more than 90% of cases. It includes methods of oriental reflexology and physiotherapy - acupressure, acupuncture, moxotherapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, the intervertebral discs flatten and the vertebrae move closer together, which leads to pinching of the spinal nerve roots. This causes pain between the shoulder blades (usually described as a sticky pile).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, sharp pain occurs suddenly and is called dorsago. In the second case, the pain is felt constantly, has an aching character and is called back pain.
Irritation caused by a pinched root spreads along the nerve, radiates into the chest and becomes the cause of intercostal neuralgia - a stabbing, cutting or burning pain in the chest, which intensifies with inhalation, movement, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart region, which is accompanied by signs of cardioneurosis - palpitations, heart palpitations, increased heart rate.
Pinching a nerve root results in disruption of innervation, numbness, hand weakness, cold feeling in the hand, cyanosis (blue discoloration), or whitening of the skin. These symptoms are usually one-sided.
Pain associated with osteochondrosis can also radiate to the shoulder, under the shoulder blade, and to the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral region, shoulders, cervical collar area, difficulty breathing, a feeling of a lump in the chest.
Nerves originating from the spinal cord in the thoracic region play an important role in innervating the entire body. Therefore, symptoms of osteochondrosis can appear in areas seemingly unrelated to the spine. This is why it is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- numbness of the body,
- pain in the right hypochondrium,
- discomfort in the abdomen,
- sweat
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, gait instability and loss of coordination.
Reasons for development, stages
Muscle spasms and tension (hypertonia) of the back muscles play the main role in the development of the disease. These spasms occur during a sedentary lifestyle, poor posture, or prolonged stay in a static, uncomfortable position (for example, in the office or while driving).
On the other hand, monotonous and strenuous physical work also causes the appearance of persistent muscle spasms of the back (for example, working with raised arms).
Muscle spasms impede circulation and hinder blood flow to the spine. As a result, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing pads of connective tissue located between the vertebrae. At the center of each disc is a pulpy, semi-fluid core that contains a lot of moisture. Water provides load resistance and compressive strength.
Along the outer perimeter of each disc is reinforced by a rigid fibrous ring. The connective tissues of the discs consist mainly of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other cartilaginous connective tissues for their continued regeneration.
Muscle spasms interfere with blood flow, resulting in not enough collagen reaching the discs for normal tissue repair. Lack of oxygen leads to a slowdown in metabolic processes.
Due to metabolic disturbances, tissue renewal of the intervertebral discs slows down and their wear accelerates. This leads to dystrophy and degenerative changes: the discs become dehydrated, crack, dry out, flatten and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive stress on the spine in the thoracic region. If in the cervical region the intervertebral discs are pressed by the weight of the head, which increases with poor posture, and the lumbar region is pressed by body weight, which increases with excess weight, then in the thoracic region, muscle spasms play an exceptional role. in the development of the disease. These spasms not only impede blood circulation, but also tighten the spine and compress the intervertebral discs day and night. Intervertebral discs are practically deprived of the possibility of not only cell renewal, but also simple rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relax tense back muscles, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
Flattening of the intervertebral discs causes the space between the vertebrae to decrease, the vertebrae to move closer together, and the nerve roots to become pinched. This causes pain, which causes a reflex muscle spasm and further increases pressure on the discs. Therefore, with the onset of pain, the development of the disease usually accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
Important!
In older people, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is manifested in particular by a reduction in height in the elderly, due to a thinning of the intervertebral discs.
During the second stage, the outer annulus fibrosus becomes defibrated. Its tissues become looser, weaker and it can no longer support the internal load. As a result, disc protrusion occurs (usually local) in the form of a protrusion.
A projection directed towards the spinal cord is called dorsal. Projections directed to the side are called lateral. The rarest case is the uniform protrusion of the disc around the entire perimeter.
The appearance of a protrusion generally leads to an increase in pain. An x-ray picture clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bone growths. They form along the edges of the vertebrae to compensate for the loads placed on the spine, as the intervertebral discs face them less and less.
In the third stage of the disease, the annulus fibrosus of the disc cannot withstand internal pressure and rupture. Through the resulting space, part of the nucleus pulposus of the disc is expelled: an intervertebral herniation occurs.
At the fourth stage of the disease, the range of movements of the back sharply decreases, the pain syndrome becomes constant and an extensive picture of neurological disorders develops.
Diagnostic
At the first appointment, the doctor asks the patient about the symptoms, the circumstances of their appearance, studies the medical history, conducts an external examination, paying attention to the posture, the presence or absence of deformities ofthe spine (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, backgia) can be both osteochondrosis and vertebral displacement (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonicity of the spinal muscles. The doctor performs palpations and uses successive pressures to look for painful points (triggers) which correspond to the centers of muscle spasms.
To obtain more detailed information, the doctor prescribes an X-ray or MRI.
X-rays of thoracic osteochondrosis provide the most general information - they help to differentiate the disease from spondylolisthesis, see osteophytes and reduce the spaces between the vertebrae.
Magnetic resonance imaging shows soft connective tissues better. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, hernia (its size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve roots and see spinal stenosis (or its danger).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatments
To relieve back pain and intercostal neuralgia in thoracic osteochondrosis, nonsteroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used. The main effect of these drugs is anti-inflammatory, therefore their use is justified in cases where a pinched nerve root is accompanied by its inflammation, that is, thoracic radiculitis. NSAIDs also reduce inflammation of muscle tissue against the background of spasms and persistent hypertension.
In case of acute pain syndrome, a paravertebral or epidural blockade can be used - an injection of an analgesic. In the first case, the injection is carried out in the place where the nerve root is pinched, in the second case, in the area between the periosteum of the vertebra and the membrane of the spinal cord.
To relieve muscle tension and reduce pressure on nerve roots, blood vessels and intervertebral discs, muscle relaxants and antispasmodics are used.
Vitamin complexes are prescribed to nourish nervous tissues and prevent their atrophy.
To slow down the process of connective tissue destruction, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can somewhat slow down the development of the disease, but in general they have practically no effect on the process of degenerative changes in the intervertebral discs.
Non-drug treatment
Non-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physiotherapy.
The main goals of treatment are relief of the inflammatory process, improvement of blood circulation and restoration of metabolic processes in the intervertebral discs, stimulation of cell renewal of connective tissues. For this purpose, the clinic uses complex therapy using the methods of oriental medicine.
Important!
Physiotherapy exercises help to form and strengthen the muscle corset, eliminate irrational loads on the spine and prevent congestion and the formation of muscle spasms.
Surgery
For large hernias, particularly dorsal hernias, presenting a risk of spinal stenosis, and especially if it is present, surgical intervention – discectomy – may be indicated.
Part of the disc is removed or the entire disc is removed and replaced with a prosthesis. Although discectomy is a common type of surgical procedure, operations on the thoracic region are extremely rare.
Treatment in clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxotherapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency is achieved due to the synergy of individual methods and the elimination of the cause of the disease.
- Acupressure. By forcefully pressing on the trigger points in the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unhindered blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced and the processes of metabolism and tissue regeneration are accelerated as the influx of oxygen and collagen increases.
- Acupuncture. Insertion of needles into bioactive points on the back, legs, arms, head and chest eliminates symptoms associated with impaired innervation - numbness, arm weakness. Through this procedure, intercostal neuralgia and other vertebrogenic pain are relieved. In addition, acupuncture enhances the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. Warming of bioactive points in the spinal area is carried out with a smoking absinthe cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle traction of the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion of the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must thoroughly relax the back muscles, eliminate spasms and free the spine. To do this, the muscles are well warmed and relaxed thanks to the massage. If this is not done, the application of physical effort can lead to injury – rupture, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, therefore they are not used clinically.
Hirudotherapy
Placement of medicinal leeches improves local blood circulation, blood supply to the intervertebral discs and has an anti-inflammatory effect.
Stone therapy
Smooth stones heated to a certain temperature are placed along the spine to deeply warm and relax the spinal muscles, improve blood circulation and stimulate blood circulation.
The duration of one treatment session in the clinic is 1-1. 5 hours, depending on individual indications. The treatment course usually includes 10-15 complex sessions. Once the treatment is completed, a control MRI is performed to evaluate the treatment results achieved.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with the development of body paralysis.
Other possible complications are associated with disruption of the innervation of the body due to pinching of spinal nerve roots: development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevention
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and monitor your posture.
Important!
If a child or adolescent has scoliosis, this disease should be cured without hoping that it will go away on its own. Lateral curvature of the spine manifests itself as increasing pain but can last a lifetime.
In this case, persistent muscle tension and spasms will be inevitable, which will lead to the development of osteochondrosis and, possibly, its complications. And this is in addition to the fact that scoliosis itself is fraught with complications in the respiratory, digestive and cardiovascular systems.